Ego Defense Mechanisms and Mental Health Nursing

Nursing Profession and Ego Defense Mechanism

Ego defense mechanisms proposed by Sigmund Freud after developmental stages.These mechanisms are Denial,Repression Projection,Displacement,Regression,Sublimation,Rationalization,and Reaction Formation.

In the View Psychologists

    Freud believed the self, or ego. uses ego defense mechanisms, which are methods of attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings, or events. Defense mechanisms are explained. For example, a person who has been diagnosed with cancer and told he has 6 months to live but refuses to talk about his illness is using the defense mechanism of denial, or refusal to accept the reality of the situation. If a person dying of cancer exhibits continuously cheerful behavior, he could be using the defense mechanism of reaction formation to protect his emotions. Most defense mechanisms operate at the unconscious level of awareness, so people are not aware of what they are doing and often need help to see the reality.

Five Stages of Psychosexual Development. Freud based his theory of childhood development on the belief that sexual energy, termed libido, was the driving force of human behavior. He proposed that children progress through five stages of psychosexual development: oral (birth to 18 months), anal (18 to 36 months), phallic/oedipal (3 to 5 years), latency (5 to 11 or 13 years), and genital (11 to 13 years). Table 3.2 describes these stages and the accompanying developmental tasks. Psychopathology results when a person has difficulty making the transition from one stage to the next or when a person remains stalled at a particular stage or regresses to an earlier stage. Freud's open discussion of sexual impulses, particularly in children, was considered shocking for his time (Freud, 1923/1962).

Transference and Counter transference Freud developed the concepts of transference and counter transference. Transference occurs when the client displaces onto the therapist attitudes and feelings that the client originally experienced in other relationships (Freud, 1923/1962). Transference patterns are automatic and unconscious in the therapeutic relationship. For example, an adolescent female client working with a nurse who is about the same age as the teen's parents might react to the nurse like she reacts to her parents. She might experience intense feelings of rebellion or make sarcastic remarks; these reactions are actually based on her experiences with her parents, not the nurse.

Counter transference occurs when the therapist displaces onto the client attitudes or feelings from his or her past. For example, a female nurse who has teenage children and who is experiencing extreme frustration with an adolescent client may respond by adopting a parental.

1:Overachievement in one area to offset real or perceived deficiencies in another area Napoleon complex diminutive man becoming emperor.

• Nurse with low self-esteem working double shifts so her supervisor will like her

2:Conversion :

Expression of an emotional conflict through the development of a physical symptom, usually sensorimotor in nature

• Teenager forbidden to see X-rated movies is tempted to do so by friends and develops blindness, and the teenager is unconcerned about the loss of sight.

3:Denial:

Failure to acknowledge an unbearable condition; failure to admit the reality of a situation or how one enables the problem to continue

• Diabetic person eating chocolate candy
• Spending money freely when broke
• Waiting 3 days to seek help for severe abdominal pain

4: Displacement

Ventilation of intense feelings toward persons less threatening than the one who aroused those feelings

• Person who is mad at the boss yells at his or her spouse
• ·    Child who is harassed by a bully at school mistreats a younger sibling.

5:Dissociation:

Dealing with emotional conflict by a temporary alteration in consciousness or identity

• Amnesia that prevents recall of yesterday's auto accident
• Adult remembers nothing of childhood sexual abuse.

6:Fixation:

Immobilization of a portion of the personality resulting from unsuccessful completion of tasks in a developmental stage

• ·   Never learning to delay gratification
• ·   Lack of a clear sense of identity as an adult

7:Identification:

Modeling actions and opinions of influential others while searching for identity, or aspiring to reach a personal, social, or occupational goal

• Nursing student becoming a critical care nurse because this is the specialty of an instructing the facts but not the emotions

8: Internationalization:

Separation of the emotions of a painful event or situation from the facts involved, acknowledge she admires

• Person shows no emotional expression when discussing serious car accident.

9: Introjection

Accepting another person's attitudes, beliefs, and values as one's own

• Person who dislikes guns becomes an avid hunter, just like a best friend.

10:Projection

Unconscious blaming of unacceptable inclinations or thoughts on an external object

• Man who has thought about same-gender sexual relationship, but never had one, beats a man who is gay
• Person with many prejudices loudly identifies others as bigots

11:Rationalization :

Excusing own behavior to avoid quilt, responsibility, conflict, anxiety, or loss of self-respect

Student blames failure on teacher being mean.

• Man says he beats his wife because she doesn't listen to him.

12:Reaction formation:

Acting the opposite of what one thinks or feels 

• Woman who never wanted to have children becomes a supermom
• Person who despises the boss tells everyone what a great boss she is

13:Regression

Moving back to a previous developmental stage to feel safe or have needs met

• Five-year-old asks for a bottle when new baby brother is being fed
• Man pouts like a 4-year-old if he is not the center of his girlfriend's attention.

14:Repression

Excluding emotionally painful or anxiety-provoking thoughts and feelings from conscious awareness woman has no memory of the mugging she suffered yesterday

• Woman has no memory before age 7, when she was removed from abusive parents.

15:Resistance:

Overt or covert antagonism toward remembering or processing anxiety-producing information

• Nurse is too busy with tasks to spend time talking to a dying patient.
• Person attends court-ordered treatment for alcoholism but refuses to participate

16:Sublimation :

Substituting a socially acceptable activity for an impulse that is unacceptable

• Person who has quit smoking sucks on hard candy when the urge to smoke arises
• Person goes for a 15-minute walk when tempted to eat junk food.

17:Substitution:

Replacing the desired gratification with one that is more readily available

• Woman who would like to have her own children opens a day care center.

18:Suppression :

Conscious exclusion of unacceptable thoughts and feelings from conscious awareness

• Student decides not to think about a parent's illness to study for a test.
• Woman tells a friend she cannot think about her son's death right now.

19:Undoing:

Exhibiting acceptable behavior to make up for or negate unacceptable behavior

• Person who cheats on a spouse brings the spouse a bouquet of roses.
• Man who is ruthless in business donates large amounts of money to charity.